| NPI | 1295175784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S7813) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 285540) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2021-07-07 |